The Cross Connection Control Program’s goal is to protect the public water supply by preventing the flow of non-potable water into the distribution system. The water purveyors are required by Part 5 of the New York State Sanitary Code to protect the distribution system by requiring customers with potential cross connections to install a backflow prevention device.
For more information regarding the Cross Connection Control Program, go to the Environmental Protection Agency and the New York State Department of Health.
What to do next
Customers are required to contact their local water purveyor for the proper type of the backflow prevention device required for their facility. Prior to installation of the device, an application packet, which must be prepared by a New York State licensed and registered professional engineer or registered architect, is submitted to the water purveyor for their original endorsement and signature and then is forwarded to the Westchester County Department of Health for review and approval.
Upon completion of the installation of the device, customers are required to have the device tested by a New York State licensed tester and to submit the completed form DOH-1013 to the water purveyor and WCDOH.
Application Packet Information
- Instruction to Request to Install and Completed Works for a Backflow Prevention Device (Updated 3/2022)
- Application for Approval of Backflow Prevention Device Form DOH-347
- Report on Test and Maintenance of Backflow Prevention Device Form DOH-1013
- Instructions for completing DOH-1013 (Rev. 1/2019)
- Certificate of Resolution for Authorization (fillable)
Additional Information
- List of NYSDOH Approve Backflow Prevention Devices (updated 7/2020)
- List of Certified Backflow Prevention Device Testers (NYSDOH) Rev. 4/2021
- NYSDOH Backflow Prevention Program
- Cross-Connection Control (EPA)